The DOI matches its Crossref record; 29 of the 29 references it cites were found in a registry or an index.
Long-term follow-up of patients with neuromyelitis optica after repeated therapy with rituximab
Abstract
BACKGROUND: Neuromyelitis optica (NMO) is a severe autoimmune disease targeting optic nerves and spinal cord. The monoclonal anti-CD20 B-cell antibody rituximab is an emerging therapeutic option in NMO. However, neither long-term efficacy or safety of rituximab, nor the correlation between B-cell counts, B-cell fostering cytokines, aquaporin-4 antibodies (AQP4-ab), and disease activity in NMO, have been investigated prospectively. METHODS: We performed a prospective long-term cohort study of 10 patients with NMO who were treated up to 5 times with rituximab as a second-line therapy. Clinical examinations, B-cell counts, and serum concentrations of BAFF (B-cell activating factor of the TNF family; also called TNFSF13b), APRIL (a proliferation-inducing ligand; also called TNFSF13), AQP4-ab, and immunoglobulin levels were measured every 3 months. RESULTS: Repeated treatment with rituximab led to sustained clinical stabilization in most patients with NMO. Disease activity correlated with B-cell depletion, but not clearly with AQP4-ab or levels of APRIL. BAFF levels increased after application of rituximab and indicated persisting efficacy of the drug but did not correlate with disease activity. Overall, rituximab was well-tolerated even after up to 5 consecutive treatment courses; however, we observed several severe adverse reactions. CONCLUSION: Our data indicate that long-term therapy with rituximab is effective in NMO as a second-line therapy and has an acceptable safety profile. Retreatment with rituximab should be applied before reappearance of circulating B cells. CLASSIFICATION OF EVIDENCE: This study provides Class IV evidence that repeated doses of rituximab result in stabilization in most patients.
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Citations
Cites
Efficacy of B-cell-targeted therapy with rituximab in patients with rheumatoid arthritis
Edwards, J. C. W., Szczepański, L., Szechiński, J., Filipowicz-Sosnowska, A., Emery, P., Close, D. R., Stevens, R. M., & Shaw, T. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa032534 · Cited by 2,623
Revised diagnostic criteria for neuromyelitis optica
Wingerchuk, D. M., Lennon, V. A., Pittock, S. J., Lucchinetti, C. F., & Weinshenker, B. G. (2006) · Neurology · doi:10.1212/01.wnl.0000216139.44259.74 · Cited by 2,574
B-cell depletion with rituximab in relapsing-remitting multiple sclerosis
Hauser, S. L., Waubant, E., Arnold, D. L., Vollmer, T., Antel, J., Fox, R. J., Bar-Or, A., Panzara, M., Sarkar, N., Agarwal, S., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0706383 · Cited by 2,439
The clinical course of neuromyelitis optica (Devic’s syndrome)
Wingerchuk, D. M., Hogancamp, W. F., O’Brien, P. C., & Weinshenker, B. G. (1999) · Neurology · doi:10.1212/wnl.53.5.1107 · Cited by 1,822
An open label study of the effects of rituximab in neuromyelitis optica
Cree, B. A. C., Lamb, S., Morgan, K., Chen, A., Waubant, E., & Genain, C. (2005) · Neurology · doi:10.1212/01.wnl.0000159399.81861.d5 · Cited by 646
Anti-aquaporin-4 antibody is involved in the pathogenesis of NMO: a study on antibody titre
Takahashi, T., Fujihara, K., Nakashima, I., Misu, T., Miyazawa, I., Nakamura, M., Watanabe, S., Shiga, Y., Kanaoka, C., Fujimori, J., et al. (2007) · Brain · doi:10.1093/brain/awm062 · Cited by 633
Intrathecal pathogenic anti–aquaporin‐4 antibodies in early neuromyelitis optica
Bennett, J. L., Lam, C., Kalluri, S. R., Saikali, P., Bautista, K., Dupree, C., Glogowska, M., Case, D., Antel, J. P., Owens, G. P., et al. (2009) · Annals of Neurology · doi:10.1002/ana.21802 · Cited by 590
Self-citationNeuromyelitis optica: Pathogenicity of patient immunoglobulin in vivo
Bradl, M., Misu, T., Takahashi, T., Watanabe, M., Mader, S., Reindl, M., Adzemovic, M., Bauer, J., Berger, T., Fujihara, K., et al. (2009) · Annals of Neurology · doi:10.1002/ana.21837 · Cited by 563
Saadoun, S., Waters, P., Bell, B. A., Vincent, A., Verkman, A. S., & Papadopoulos, M. C. (2010) · Brain · doi:10.1093/brain/awp309 · Cited by 548
Serologic changes following B lymphocyte depletion therapy for rheumatoid arthritis
Cambridge, G., Leandro, M. J., Edwards, J. C. W., Ehrenstein, M. R., Salden, M., Bodman‐Smith, M., & Webster, A. D. B. (2003) · Arthritis & Rheumatism · doi:10.1002/art.11181 · Cited by 470
Cited by
B cell depletion therapies in autoimmune disease: advances and mechanistic insights
Lee, D. S. W., Rojas, O. L., & Gommerman, J. L. (2021) · Nature Reviews Drug Discovery · doi:10.1038/s41573-020-00092-2 · Cited by 658
Neuromyelitis Optica Study Group (NEMOS), Trebst, C., Jarius, S., Berthele, A., Paul, F., Schippling, S., Wildemann, B., Borisow, N., Kleiter, I., Aktas, O., et al. (2014) · Journal of Neurology · doi:10.1007/s00415-013-7169-7 · Cited by 595
Self-citationJarius, S., Paul, F., Weinshenker, B. G., Levy, M., Kim, H. J., & Wildemann, B. (2020) · Nature Reviews Disease Primers · doi:10.1038/s41572-020-0214-9 · Cited by 478
A 5-Year Follow-up of Rituximab Treatment in Patients With Neuromyelitis Optica Spectrum Disorder
Kim, S.-H., Huh, S.-Y., Lee, S. J., Joung, A., & Kim, H. J. (2013) · JAMA Neurology · doi:10.1001/jamaneurol.2013.3071 · Cited by 324
Mealy, M. A., Wingerchuk, D. M., Palace, J., Greenberg, B. M., & Levy, M. (2014) · JAMA Neurology · doi:10.1001/jamaneurol.2013.5699 · Cited by 302
Metadata
- Authors
- Pellkofer, H. L., Krumbholz, M., Berthele, A., Hemmer, B., Gerdes, L. A., Havla, J., Bittner, R., Canis, M., Meinl, E., Hohlfeld, R., & Kuempfel, T.
- Venue
- Neurology
- Published
- 2011-04-12
- Volume
- 76
- Issue
- 15
- Pages
- 1310-1315
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2021279859
- Cited by
- 296
- References
- 29
- FWCI
- 15.60
- Type
- journal article
- Language
- en
- Open access
- closed
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- Pellkofer, H. L., Krumbholz, M., Berthele, A., Hemmer, B., Gerdes, L. A., Havla, J., Bittner, R., Canis, M., Meinl, E., Hohlfeld, R., & Kuempfel, T. (2011). Long-term follow-up of patients with neuromyelitis optica after repeated therapy with rituximab. Neurology. https://doi.org/10.1212/wnl.0b013e3182152881
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